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Association Between Cigarette Smoking Frequency and Tobacco Use Disorder in U.S. Adults

Published:December 22, 2020DOI:https://doi.org/10.1016/j.amepre.2020.10.019
      Cigarette smoking remains a major cause of premature death and nicotine dependence is a major barrier to smoking cessation.
      WHO. WHO report on the global tobacco epidemic 2017: monitoring tobacco use and prevention policies.
      ,
      HHS
      The health consequences of smoking—50 years of progress: a report of the Surgeon General.
      The DSM-5 is the primary guide to psychiatric diagnoses in the U.S. The 5th revision, released in 2013, replaced the term nicotine dependence and instead assigns the diagnosis tobacco use disorder (TUD) to individuals experiencing clinically significant impairment, as indicated by meeting at least 2 of 11 specified criteria.
      American Psychiatric Association
      Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
      Clinical practice guidelines encourage clinicians to routinely assess and treat tobacco use and dependence.
      Treating tobacco use and dependence: 2008 update. Agency for Healthcare Research and Quality.
      Patient's self-reported smoking rate is often used to guide clinical decision making, but surprisingly, no previous report has described the proportion of cigarette smokers who meet DSM-5 TUD criteria across the full range of cigarette use patterns in a representative sample of the U.S. population. Lighter smoking is frequently perceived as less harmful. Consequently, such smokers may be less likely to be identified by medical providers and less likely to receive appropriate treatment.
      • Schane RE
      • Glantz SA
      • Ling PM.
      Nondaily and social smoking: an increasingly prevalent pattern.
      Information on the true prevalence of TUD in this population can directly inform clinical practice.
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